Various intervention techniques may reduce choking. Implicit learning strategies, such as analogy learning, have been found effective in table tennis44. This intervention provides support for EMT by showing that reductions in the amount of explicit movement knowledge acquired decreases performance failure under pressure. However, Syed was already an expert when the choke occurred, therefore changing technique via implicit learning risks causing movement hypothesis testing and reducing overall performance standard32. In-the-moment attention strategies would be more suitable to reduce the risk of Syed choking again; using analogies during performance as a concentration strategy could help Syed avoid explicit monitoring (e.g. ‘hit the ball up the hypotenuse’)36.

Adopting an external focus is a useful intervention strategy. Much like EMT, the Constrained Action Hypothesis suggests that athletes adopting an internal focus will increase awareness of movements, constraining self-organisation of the motor system and disrupting automatic movements. In contrast, when an external focus is assumed, the effects of movements receive attention, allowing the motor system to self-organise and skill execution to be elicited automatically57. This has been supported by research at the psychological level (attention to golf club enhances performance, whilst attention to arm reduces it)59, and at the neuromuscular level (recruitment of motor units is more efficient with an external focus)53.

The benefits of adopting an external focus can also be explained by internal focus increasing knowledge of explicit rules; whilst still supporting EMT, attentional focus may reduce choking indirectly through decreased declarative knowledge45. Regardless of whether external focus has a direct or indirect effect, it is an intervention that Syed could use whilst playing (e.g. focusing on the bat rather than his hand). Syed’s coach could also play a role; by giving external focus feedback his coach would encourage self-organisation of Syed’s motor system, allowing for automatic skill execution58.

Clutching the left hand can be helpful in reducing explicit monitoring. Hemisphere-Specific Priming has been found to eliminate performance failure under pressure5. Inferior performance among experts has been associated with high left-hemispheric activation so inhibiting activity in the left hemisphere (linked to verbal-analytic processing and conscious control) or increasing activation in the right hemisphere (associated with visuo-spatial processes underlying execution of automated skills) may prevent choking10. Performance enhancement has been found when inhibiting the left-temporal lobe using transcranial magnetic stimulation48 and via neurofeedback-induced activation of the right hemisphere33. A recent study found participants who squeezed their left hand pre-performance eliminated performance decrements under conditions of increased self-focus and situational pressure. In contrast, participants who squeezed their right hand, therefore increasing verbal-analytic conscious processing, choked5.

Correlation between left-hemispheric inhibition and right-hemispheric activation reducing choking supports the conscious processing hypothesizing of EMT, and, because hand-squeezing was used as a control condition, this increases the likelihood that choking was caused by a change in hemispheric processing rather than distraction5. Further research is required to ascertain whether athletes who squeezed their left hand suppressed the conscious control regions in the left hemisphere, or increased activation in the automatic behaviour associated areas of the right hemisphere.

As Syed is right handed, this technique could aid his performance in two ways. Syed could squeeze his left hand to increase right-hemispheric activation, or/and reduce the tightness of his right hand’s hold on the bat, decreasing activation in the left-hemispheric brain areas responsible for conscious control. The large number of left-handed athletes playing at a high-level in sports such as tennis and fencing supports EMT and Hemisphere-Specific Priming as an intervention strategy; clutching the bat/racquet/club in the left hand will cause less communication with left-hemispheric verbal-analytic regions, reducing explicit monitoring38.

Reducing anxiety (e.g. progressive relaxation, meditation and biofeedback)17 and training under elevated levels of anxiety have shown to be effective in reducing choking42. Research shows that increased anxiety is accompanied by increased self-focus and increased explicit monitoring54. Becoming accustomed to heightened anxiety may eliminate choking as the athlete acclimatizes to the cognitive processes accompanying it.

Basketball players who practised free throws under conditions of elevated anxiety (anxiety manipulation was ensured using the anxiety thermometer) remained unaffected during the high anxiety post-test, whereas the control group who had not practised under high anxiety conditions could not maintain their level of performance. Results suggest that it is not that athletes no longer experience anxiety, but that they adapt to perform with it42.

Whilst EMT cannot explain why repeated exposure to anxiety improves performance under pressure (interference with automatic processes would still be expected to occur regardless of acclimatization), PET can account for these findings with athletes attempts to reduce negative effects of anxiety becoming more effective with repeated exposure42, highlighting how self-focus and distraction theories are not mutually exclusive but situationally dependent.

Whilst difficult to replicate the anxiety of an Olympic table tennis match, imaging skill execution has been found to activate functionally equivalent brain areas to those used during actual skill execution46. A six week intervention for penalty kicks using the PETTLEP model of imagery lead to a significant improvement in performance24. Using specific imagery based on the PETTLEP model could help Syed to recreate the pressures, emotions and physiological responses he experiences in competition34.

In conclusion, EMT has contributed to understandings of why athletes choke under pressure and can account for the cognitive aspects of Syed’s choking experience. Empirical, anecdotal and neuropsychological evidence supports EMT’s account for performance failure caused by athletes consciously monitoring usually automatic skill execution when under pressure40 . For more complex skills requiring WM, research supports distraction theories55 suggesting there are multiple routes to skill failure depending on task and level of expertise11. Evidence shows intervention strategies that prevent explicit monitoring and reduce accumulation of declarative knowledge (e.g. analogy learning, attentional focus and hemisphere-specific priming) are effective in reducing choking, supporting EMT and providing strategies Syed can implement in his training and performance.

Whilst research into choking under pressure remains predominantly situated in the experimental paradigm (e.g the ‘biggest ever study of the psychology of pressure’ has been launched online)4, EMT based intervention strategies have been criticised for being a ‘quick fix’14. Critical approaches can offer greater insight into aspects of choking which are not amenable to experimentation, encouraging a synthesis of cognitive-behavioural ‘suppressive’ and psychoanalytic ‘expressive’ interventions14.

Future research should consider the situational specifics of choking, decoupling monitoringfrom controlling skill execution28, and adopting a positive psychology approach focusing on ‘fostering excellence’ rather than ‘repairing’ pressure-induced ‘damage’50. With only 17 studies on flow in elite sport published in the last 10 years, future research should consider the application of EMT to ‘clutch’ performances, (‘any superior performance which occurs under pressure circumstances’)41. Just as EMT has contributed to cause-effect explanations of choking under pressure, with further research the theory could help to discover the ‘causal mechanisms’ of optimised performance under pressure5.

EMT is helpful in explaining why Syed and other elite athletes choke under pressure, but athletes’ experiences should not be dictated by a theory27. In practice, acknowledging athletes’ individuality and putting them in charge of their thoughts, emotions and behaviours is of vital importance.